新疆癫痫患儿拉考沙胺血药浓度的影响因素探讨

目的：探讨年龄、性别、体质指数（body mass index，BMI）、族别和合并用药对新疆地区癫痫患儿拉考沙胺（lacosamide，LCM）稳态血药浓度的影响。方法：收集2019-2021年就诊于某院并规律服用LCM的0~14岁癫痫患儿的血清样本103例，用超高效液相色谱法进行血药浓度测定，并分析患儿年龄、性别、BMI、族别、给药剂量及合并用药等因素对其血药浓度的影响。结果：LCM的浓度剂量比（concentration-dose ratio，CDR）结果在男女性别之间的差异无统计学意义（t=-0.332；P=0.741）。学龄期年龄组患儿的CDR结果显著高于婴幼儿期和学龄前期组患儿（t=2.225，P=0.030；t=2.830，P=0.006）。BMI<18.5组患儿的CDR结果显著低于18.5≤BMI<24.0和BMI≥24.0组患儿（t=-2.876，P=0.006；t=-3.761，P=0.004）。维吾尔族癫痫患儿的CDR结果显著高于汉族癫痫患儿（t=-2.588，P=0.011）。结论：患儿临床应用LCM进行抗癫痫治疗，有必要对其进行血药浓度监测，以期为其个体化给药方案的建立提供理论依据。

Influencing factors of serum concentration of lacosamide in epileptic children in Xinjiang

OBJECTIVE To explore the effects of age, gender, body mass index (BMI), ethnicity and combined use of antiseizure medications (ASMs) on the steady-state serum concentration of lacosamide (LCM) in epileptic children.METHODS The serum samples were collected from 0 to 14-year-old epileptic children from 2019 to 2021. The serum concentrations were determined by ultra-high performance liquid chromatography (UPLC). And the effects of age, gender, BMI, ethnicity, dose and combined use on serum concentration were examined.RESULTS No significant difference existed in the ratio of concentration dose (CDR) results of LCM between males and females (t=-0.332; P=0.741). The results of CDR in school-age children were significantly higher than those in infants and preschool children (t=2.225, P=0.030; t=2.830, P=0.006). The result of CDR was significantly lower in BMI<18.5 group than that in 18.5≤BMI<24.0 group and BMI≥24.0 group (t=-2.876, P=0.006; t=-3.761, P=0.004). The result of CDR was significantly higher in Uygur epileptic children than that in Han epileptic counterpart (t=-2.588, P=0.011).CONCLUSION It is necessary to monitor the blood concentration of LCM in children on antiepileptic therapy, especially when combined with other ASMs to provide a theoretical basis for formulating individualized drug dosing regimens.